National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 10/15/2021 release of VAERS data:

Found 800,916 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 202 out of 8,010

Result pages: prev   103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 265 266 267 268 269 270 271 272 273 274 275 276 277 278 279 280 281 282 283 284 285 286 287 288 289 290 291 292 293 294 295 296 297 298 299 300 301   next


VAERS ID: 1700073 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-11
Onset:2021-09-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chills, Extra dose administered, Hypersensitivity, Injection site erythema, Injection site pruritus, Pyrexia
SMQs:, Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Arthritis (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: Healthy as a horse
Preexisting Conditions: None
Allergies: None to my knowledge
Diagnostic Lab Data: Did not go to the hospital.
CDC Split Type:

Write-up: After 24 hours all joints hurt. A fever (99.6) came. Could not keep from shivering in spite of wearing a heavy jacket. Took a couple of pain killers. Later in the day the fever broke. and felt human again. My upper left arm is reddish and itchy. I believe I have an allergy and feel pretty strongly that it was the third dose. The two first doses did not give me any problem.


VAERS ID: 1700086 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-12
Onset:2021-09-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Angiogram normal, Blood creatinine normal, Blood glucose normal, Full blood count normal, Heart rate increased, Metabolic function test normal, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol, Motrin PRN
Current Illness: Denies
Preexisting Conditions: Headaches
Allergies: NKDA
Diagnostic Lab Data: 12 Sep 2021. Non-Con CTA of head negative. CTA of head and neck negative. CBC nml, Creatinine 1.11 mg/ml, Glucose 125mg/dL. All other CMP values NML.
CDC Split Type:

Write-up: Member reported unilateral left sided tingling to cheek. Also reports increased rapid heart rate.


VAERS ID: 1700143 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-05-04
Onset:2021-09-12
   Days after vaccination:131
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / N/A LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Cough, Dyspnoea, Respiratory tract congestion, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: HTN
Allergies:
Diagnostic Lab Data: POSITIVE SARS-COV-2 BY PCR
CDC Split Type:

Write-up: This case meets vaccine breakthrough criteria review. SXS SOB, COUGH, CHEST CONGESTION


VAERS ID: 1700185 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-01
Onset:2021-09-12
   Days after vaccination:164
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8737 / 2 AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute kidney injury, Blood creatinine increased, COVID-19, Condition aggravated, Diarrhoea, Dysuria, Humerus fracture, Hypophagia, Hypotension, Hypovolaemia, Micturition urgency, Nausea, Oesophagogastroduodenoscopy, Pollakiuria, SARS-CoV-2 test positive, Tachycardia, Urinary tract infection, Urine analysis abnormal, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Pseudomembranous colitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Chronic kidney disease (broad), Noninfectious diarrhoea (narrow), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (narrow), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 325 MG tablet ADVAIR DISKUS 500-50 MCG/DOSE diskus inhaler albuterol (PROVENTIL) (2.5 MG/3ML) 0.083% nebulization albuterol HFA (PROVENTIL HFA, VENTOLIN HFA, PROAIR HFA) 108 (90 Base) MCG/ACT inhaler ARIPiprazole (AB
Current Illness: 8.12.21 - EGD 9.2.21 - fractured right shoulder 9.11.21 - COVID-19 positive
Preexisting Conditions: OSA (obstructive sleep apnea)- poor tolerance to CPAP, will switch to BiPAP Morbid obesity Diabetes mellitus HTN (hypertension) Depression Hypothyroidism Left wrist tendinitis De Quervain''s tenosynovitis, left Excessive sleepiness Hypersomnia with sleep apnea Sinus congestion Hypertension Congenital heart disease in adult Scimitar syndrome H/O surgery to heart and great vessels, presenting hazards to health SVT (supraventricular tachycardia) History of cardiac radiofrequency ablation (RFA) Allergic rhinitis Asthma, mild intermittent, well-controlled Diabetes mellitus type 2, insulin dependent Hypercholesteremia Closed fracture of proximal end of right humerus with routine healing COVID-19 virus infection
Allergies: ibuprofen
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized (9.11.21); COVID-19 positive (9.11.21); fully vaccinated Admission Date: 9/11/2021 Discharge Date: 09/13/2021; Discharge Disposition: home or self care DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: AKI (acute kidney injury) Acute vomiting Hypotension due to hypovolemia HOSPITAL COURSE: Patient is a 51 yo female with PMH of hypertension, obstructive sleep apnea, type 2 diabetes mellitus, and proximal atrial fibrillation status post ablation who was admitted for acute kidney injury and COVID infection. Patient had several days of nausea, vomiting, and diarrhea preceding her presentation. She was also unable to hold down any food or drink fluids. She also understood 3 day history of dysuria, urgency, and frequency. She was also taking her home Lasix despite poor oral intake. In the emergency department, patient was noted to be hypotensive and tachycardic. She received 4 L of IV fluid with improvement. She had a creatinine of 1.49 (normal baseline). UA was also positive. She was also noted to be COVID-19 positive. She was admitted to the general medicine service for IV fluid hydration and started on IV ceftriaxone for uncomplicated urinary tract infection. The patient quickly improved and her AKI resolved. She reported resolution of her dysuria, nausea, and vomiting. Of note, patient reports chronic diarrhea for the last 3-4 months with loose stools for which she has seen a gastroenterologist and plans to continue to follow-up with them. Patient remained in stable condition on room air with no symptoms on day of discharge. Urine culture was still pending at discharge, however given her resolution of symptoms and 3 days of IV ceftriaxone patient was not continued on any oral antibiotics on discharge. She was counseled to adequately hydrate herself and self quarantine. She was discharged home in stable condition on 09/13.


VAERS ID: 1700326 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-25
Onset:2021-09-12
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysmenorrhoea, Heavy menstrual bleeding, Thrombosis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: I have an IUD that has prevented me from menstruating for 6 months or more. More than 2 weeks after receiving my first shot, I started having a heavy period with cramps, clots, and bright red blood. I have read that this is a side effect and I want it reported that it definitely has been for me.


VAERS ID: 1700334 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-12
Onset:2021-09-12
   Days after vaccination:184
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Oxygen saturation decreased, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: HTN, Atherosclerosis of bilat legs, meningioma of brain
Allergies: Lisinopril (swelling), Choline and Magnesium salicylate (swelling of face)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt acquired covid-19 several months after administration of vaccine that requires hospitalization. Symptoms include sever, cough, decreased O2 saturation requiring supplemental oxygen administration.


VAERS ID: 1700357 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-09-10
Onset:2021-09-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Reports chest tightness and difficulty taking deep breaths, starting on 9/12/21.


VAERS ID: 1700373 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-09-10
Onset:2021-09-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Cough, Injection site erythema, Nasal congestion, Pain, SARS-CoV-2 test, Upper respiratory tract infection
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: none
Preexisting Conditions: anxiety, HTN, PCOS
Allergies: codeine
Diagnostic Lab Data: Performed COVID 19 testing at PCP office, results pending
CDC Split Type:

Write-up: Erythema at injection site; URI symptoms (body aches, non-productive cough, and nasal congestion)


VAERS ID: 1700398 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-06-28
Onset:2021-09-12
   Days after vaccination:76
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017B21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 02B21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Tested positive for COVID 19 9/12/2021


VAERS ID: 1700431 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-10
Onset:2021-09-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Hyperhidrosis, Mobility decreased, Nausea, Vertigo
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Awoke 36 hours later with severe vertigo. Could not get out of bed, turn head for 3 days. Severe spinning, naseau and sweating.


VAERS ID: 1700443 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-11
Onset:2021-09-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FDB183 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fatigue, Headache, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Aspirin, Pantoprazole, Levothyroxine, Desvenlafaxine
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Extreme exhaustion the next two days, dizziness, headaches, fever


VAERS ID: 1700463 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-11
Onset:2021-09-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF 2588 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Decreased appetite, Dizziness, Dizziness postural, Dysstasia, Fall, Feeling of body temperature change, Fluid intake reduced, Headache, Impaired work ability, Loss of consciousness, Mobility decreased, Muscle spasms, Musculoskeletal chest pain, Musculoskeletal stiffness, Neck pain, Pain
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies: latex allergy
Diagnostic Lab Data:
CDC Split Type:

Write-up: Complete body aches and pains by 2:30 AM. Headache was very bad at 3:30 AM that required treating with Tylenol, but as I was getting a glass of water to wash down the medication, I passed out and fell to the floor. being so early in the morning, the rest of the family was sound asleep on the second floor. Eventually I did manage to get to the couch. Later in the morning, my husband helped me to the bedroom on the second floor. By the time we reached the top of the steps, I could feel myself almost close to passing out again. This would occur every time I tried to sit or stand throughout the day on 9-12-21. I could not get fluids in nor did I have an appetite. The extreme hot and cold chills would come at the same time. Taking 1000 mg of Tylenol every six hours barely blocked the pain. By Sunday evening, my neck became very stiff and sore to where I could not turn my head of touch my chin to my chest. Every rib felt like it had been hit by a board. Then the back spasms started in my lower back. This combination continued well into Monday (9-13-21) where I had to call in to work and tell them I was not able to come in. By late Monday I was able to sit up for short periods of time and stand very short periods of time before I had to lie back down. I was able to start getting fluids in more Monday and eat a small portion of food. Tuesday (9-14-21) I had to report to work, which was difficult as I still had a hard time turning my head from side to side. Dizziness and headaches were par for the course all day. I did not stay at work long and had to leave before the end of the day.


VAERS ID: 1700490 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-11
Onset:2021-09-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Injection site erythema, Injection site mass, Injection site pruritus, Pain in extremity
SMQs:, Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: CBD
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sore arm, itchy, red lump under skin where injection was given, lower back pain


VAERS ID: 1700550 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-15
Onset:2021-09-12
   Days after vaccination:150
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008B21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045B21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: tested positive for COVID 19 09/12/2021


VAERS ID: 1700648 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-08-03
Onset:2021-09-12
   Days after vaccination:40
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Musculoskeletal discomfort
SMQs:, Rhabdomyolysis/myopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness:
Preexisting Conditions:
Allergies: nka
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient contacted pharmacy on 9/15/21 stating he has been experiencing discomfort in his left shoulder for the last 3 days. There was a language barrier, so he was having difficulty describing exactly what he was feeling. He complained of his shoulder "not feeling right". He was advised to consult with his physician for follow up


VAERS ID: 1700662 (history)  
Form: Version 2.0  
Age: 95.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-27
Onset:2021-09-12
   Days after vaccination:47
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Adenovirus test, Asymptomatic COVID-19, Respiratory viral panel
SMQs:, COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 325 mg tabletcephalexin (KEFLEX) 500 m
Current Illness:
Preexisting Conditions: Nervous Post herpetic neuralgia SAH (subarachnoid hemorrhage) (CMS/HCC) Circulatory Hemorrhoids Chronic systolic
Allergies: Sulfa (Sulfonamide Antibiotics)DarifenacinOther (document deta
Diagnostic Lab Data: 09/12/21 1452 Respiratory virus detection panel Collected: 09/12/21 1244 | Final result | Specimen: Swab from Nasopharynx Adenovirus Not Detected Mycoplasma pneumoniae Not Detect
CDC Split Type:

Write-up: ASYMPTOMATIC


VAERS ID: 1700683 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-12
Onset:2021-09-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301358A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Induration, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: guinea pigs
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash and itching; the patient''s mother describes some of the rash as hard. I have not personally observed the rash.


VAERS ID: 1700697 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-15
Onset:2021-09-12
   Days after vaccination:150
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Chest X-ray normal, Chills, Culture urine positive, Device related infection, Klebsiella infection, Malaise, Nausea, Pyrexia, SARS-CoV-2 test positive, Urine abnormality
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Proteinuria (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PMH of Afib, CVA, CAD/CABG, DMII, HLD, HTN, indwelling foley
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented to the ED on 9/12/21 with report of fevers, chills, malaise, and nausea for 1 week PTA. Patient was found to be COVID positive in the ED on 9/12 (despite being fully vaccinated for COVID), but his chest X-ray was negative for pneumonia. His foley bag had cloudy urine suspicious for infection, so antibiotics were started. Patient''s urine culture later grew out Klebsiella pneumoniae. Patient has now been hospitalized for 3 days, and he has not been hypoxic since admission. Therefore, patient''s febrile illness is believed to be a combination of COVID and CAUTI. Patient is not currently on any treatment for COVID since he is not hypoxic.


VAERS ID: 1700725 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-11
Onset:2021-09-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pruritus, Injection site rash
SMQs:, Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt said that she has a silver dollar size rash at the injection site that is very itchy. It is still getting worse and not getting better. She will be following up with her doctor.


VAERS ID: 1700893 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Female  
Location: Wyoming  
Vaccinated:2021-09-11
Onset:2021-09-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Condition aggravated, Fall
SMQs:, Guillain-Barre syndrome (broad), Accidents and injuries (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Eliquis 5mg Atovastatin Levothyroxine Pantoprazole
Current Illness: weakness
Preexisting Conditions: Pacemaker, hypertension, hypothyroidism, gerd
Allergies: Septra, Advil, Demerol
Diagnostic Lab Data:
CDC Split Type:

Write-up: Weakness with fall. Patient recovering slowly after 4 days in hospital


VAERS ID: 1700944 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-09-12
Onset:2021-09-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Asthenia, Decreased appetite, Erythema, Fatigue, Headache, Nausea, Pain, Pain in extremity, Skin warm, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Severe headache, severe abdominal pain, nausea, tiredness, lack of energy, generalized body aches (2.5 days) vomiting (1 episode the morning after injection was received) lack of appetite (1 day) chills (0.5 day) left arm pain, redness, swelling, and warmth (3 days and persists but has improved) Mild headache and body aches persist Symptoms treated with self care at home and OTC medications - Naproxen, Headache/Migraine Relief, Acetaminophen Symptoms have improved significantly but some persist as stated above


VAERS ID: 1700957 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-09-12
Onset:2021-09-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Interchange of vaccine products
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT COMPLETED TWO SHOT SERIES OF MODERNA COVID SHOTS 7 MONTHS BEFORE AND WAS GIVEN PFIZER COVID SHOT AS A BOOSTER. NO ADVERSE EFFECTS REPORTED TILL TODAY


VAERS ID: 1701294 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-09
Onset:2021-09-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: I had severe Hives all over body, itching, headache for 2 days. Went to urgent care and they gave me a steroid.


VAERS ID: 1701889 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-11
Onset:2021-09-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Dyspnoea, Fatigue
SMQs:, Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Breo, Losartan, Loratadine, Azalestine
Current Illness:
Preexisting Conditions: Asthma
Allergies: Dilaudid
Diagnostic Lab Data: no tests done
CDC Split Type:

Write-up: Feeling shortness of breath since the day vaccine was received. Hard time catching my breath. Back pain started 4 days after vaccine and feeling fatigue since the day of the vaccine


VAERS ID: 1701922 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-12
Onset:2021-09-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Hypoaesthesia eye, Hypoaesthesia oral, Pharyngeal hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Corneal disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cholestiramine
Current Illness:
Preexisting Conditions: Crohn''s disease
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: numbness in my throat, jaw, face nose, tongue, eyes and forehead


VAERS ID: 1703875 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-24
Onset:2021-09-12
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047A21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, COVID-19, Cough, Dyspnoea, Pyrexia, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: COPD, HTN
Allergies: bee stings
Diagnostic Lab Data: Covid-19 positive
CDC Split Type:

Write-up: Patient admitted to hospital with positive covid-19 breakthrough case. Generalized weakness, cough, fever. O2 saturation 84% on room air. Increasing SOB. Currently on 3 L NC.


VAERS ID: 1703935 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-09-11
Onset:2021-09-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Body temperature fluctuation, Dizziness, Fatigue, Headache, Injection site pain, Metabolic function test, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: With 1st two pfizer vaccine had similar reactions minus the lightheaded dizziness
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 9/16- CMP
CDC Split Type:

Write-up: 9hrs after-site soreness, fever 100.9, body aches 24hrs after- site sorness, fever 101, body aches, extreme fatigue 48hrs after- temp 99.8, fatigue, extreme headache, nausea, extremely lightheaded and dizzy 72hrs and 96hrs after- temp fluctuation 99-101, mild fatigue, mild headache, extremely lightheaded and dizzy


VAERS ID: 1704073 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-01
Onset:2021-09-12
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / UNK LA / -

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Headache, Hyperhidrosis, Retching
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zinc vitamin c NAC Paroxatine Metropolol Asprin Vitamin D3
Current Illness: None
Preexisting Conditions: RA, heart
Allergies: Codine. Lortab Gabapentin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 09/13/2021, @ 07:00 pm I was sitting and started sweating profusely then was very dizzy and started to dry heave. This lasted for 3 hours. Severe Covid headache for 3 days after vaccine.


VAERS ID: 1704120 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-25
Onset:2021-09-12
   Days after vaccination:171
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 019B21A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Fatigue, Feeling abnormal, Laryngitis, Oropharyngeal pain, Pain
SMQs:, Anaphylactic reaction (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Rosuvastatin; Omeprazole; Methotrexate; Folic acid; Cyclobenzaprine; Vimpat; Potassium Citrate; Hydrochlorothiazide; Metamucil, Prednisone, Oxycodone; Methocarbamol
Current Illness: Did test COVID positive on 4/16/21, received second Moderna dose on 4/27/21
Preexisting Conditions: GERD'' kidney stones; hypertension, seizure disorder; rheumatoid arthritis involving multiple sites; diverticulosis, history of breast cancer
Allergies: Sulfa drugs; Morphine; Demerol; Plaquenil; black dye; adhesive tape; seafoodl acetermra; flomax; arava
Diagnostic Lab Data:
CDC Split Type:

Write-up: sore throat, and was feeling poorly. She has had fatigue, fits of dry cough, and laryngitis in the morning along with body aches starting 9/12 and 9/13/21


VAERS ID: 1704135 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-09-11
Onset:2021-09-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chills, Decreased appetite, Fatigue, Headache, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vit. C
Current Illness: none
Preexisting Conditions: none
Allergies: latex allergy and seasonal allergies
Diagnostic Lab Data: none
CDC Split Type:

Write-up: generalized muscle and joint aches/pains, chills, fever, nausea, significant fatigue and weakness, headache, inappetence; aches and pains started at 3am on 9/12/2021 and intensified throughout the following hours until their peak around 11am; approximately 7pm on 9/12/2021 is when the symptoms, other than headache and fatigue started to resolve.


VAERS ID: 1704287 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-11
Onset:2021-09-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / ECDOH / 1 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Cold sweat, Confusional state, Feeling abnormal
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Sulphur
Diagnostic Lab Data: Refused ambulance. Going to urgent care
CDC Split Type:

Write-up: Confusion, brain fog, cold sweat on face and neck. Unable to formulate sentence or to figure out how to anything such as figure out exits, not sure of whereabouts.


VAERS ID: 1704303 (history)  
Form: Version 2.0  
Age: 99.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-20
Onset:2021-09-12
   Days after vaccination:235
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood creatinine increased, COVID-19, Confusional state, Cough, Disorientation, Dyspnoea, Lethargy, Mental status changes, Productive cough, SARS-CoV-2 test positive, Somnolence
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: CKD, diabetes, hypertension, GERD, diastolic HF, hyperlipidemia, osteoporosis
Allergies: no known
Diagnostic Lab Data: COVID Symptomatic + 9/13/2021
CDC Split Type:

Write-up: Day 3 of hospitalization first dose 12/30/2020 100-year-old female sent from nursing home to ED due to AMS x1 day, and elevated creatinine, patient is a poor historian, and history was mainly taken from ED physician/ ED records, apparently, patient was found by nursing home staff, lethargic, sleepy, confused, and disoriented at approximately 9:00 a.m. this morning, with shortness of breath, and occasional cough, with mild sputum production, there has been no, fever, chills, vomiting, diarrhea, patient was in no pain, and in no apparent distress.


VAERS ID: 1704390 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-03
Onset:2021-09-12
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Injection site erythema, Injection site pruritus, Injection site rash, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 1 baby aspirin daily
Current Illness: None
Preexisting Conditions: fibromyalgia
Allergies: allergic to acetominophen
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Itchy, red, warm, spreading rash on around injection site. Started Sunday, 9/12. Still spreading on Thursday, 9/16.


VAERS ID: 1704457 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-22
Onset:2021-09-12
   Days after vaccination:202
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9809 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Vaccine breakthrough infection
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vaccine breakthrough, symptomatic. Inpatient admit 9/12-9/16.


VAERS ID: 1704476 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-08
Onset:2021-09-12
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Chest pain, Headache, Hyperhidrosis, Myalgia, Pyrexia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: Had COVID on July 27th to mid august
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Really bad fever, stomach aches. Really bad sweating, muscle aches, little headache. Fainted for a few seconds. Felt heart area hurting


VAERS ID: 1704573 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: New York  
Vaccinated:2021-09-11
Onset:2021-09-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1816022 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Chest discomfort, Dizziness, Feeling abnormal, Migraine, Nausea, Vertigo, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zinc; Vit D
Current Illness: Psoriatic arthritis and Lyme disease
Preexisting Conditions: Psoriatic arthritis and Lyme disease
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chest pressure, dizziness, vertigo, nausea, vomiting, extreme pain in joints, brain fog, migraine that has not gone away


VAERS ID: 1704648 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-09-09
Onset:2021-09-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Cardiac arrest
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Cardiomyopathy (broad), Respiratory failure (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Received second Covid immunization 9/9. Suffered cardiac arrest 9/11.


VAERS ID: 1704697 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Unknown  
Vaccinated:2020-02-10
Onset:2021-09-12
   Days after vaccination:580
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Work       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT HAD PFIZER COVID VACCINES ON Dose 1 date: 02/10/2020, Dose 2 date: 03/03/2021, AND TESTED POSITIVE TO COVID.


VAERS ID: 1704853 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Idaho  
Vaccinated:2021-09-08
Onset:2021-09-12
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aphthous ulcer, Chills, Hyperhidrosis, Pain, Paraesthesia, Pyrexia, Rash, Rash pruritic, SARS-CoV-2 test negative, Streptococcus test negative, Tonsillar hypertrophy, Urticaria, Vaccination site pain
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Strep test(9/11) and COVID (taken 9/11, result 9/15)test came back negative.
CDC Split Type:

Write-up: Evening of Vaccination soreness to touch at vax site. No new symptoms day after. 2 days after (chills, fever, body aches) Took Naproxen to help with body aches. 3 days after (swollen tonsils/canker sores on tonsils, profuse sweating) Took naproxen for tonsil pain and had a negative strep test and negative COVID test. 4 days after (hives appeared on hands and mild tingling in the finger tips). 5 Days after (hypersensitivity in finger tips, Hives became very itchy and painful) Took Benadryl and used ice packs on the hands, only ice helped. 6-7 days after (hives became more manageable, finger tips lost feeling and developed thick calluses, tonsil pain returned) salt gargle and numbing throat spray used. Lack of feeling in fingertips and severe pain from tonsil canker sore continue through today (9/16). I visited Primary Health on 9/11. Hives/other hand issues occurred 9/12 and doctor was not visited for those events.


VAERS ID: 1704996 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-11
Onset:2021-09-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014C21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Herpes zoster, White blood cell count increased
SMQs:, Neuroleptic malignant syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Armour Thyroid
Current Illness: Bad allergies
Preexisting Conditions:
Allergies: Penicillin
Diagnostic Lab Data: High white blood cell count
CDC Split Type:

Write-up: Shingles


VAERS ID: 1705981 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-10
Onset:2021-09-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood disorder, Deep vein thrombosis, Injection site pain
SMQs:, Haematopoietic cytopenias affecting more than one type of blood cell (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Site: Pain at Injection Site-Mild, Systemic: Blood Disorder (diagnosed by MD)-Severe, Systemic: dvt-Severe, Additional Details: pt diagnosed with dvt blood clot in right leg 2 days after vaccine.


VAERS ID: 1706447 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-09-12
Onset:2021-09-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Site: Itching at Injection Site-Mild, Site: Redness at Injection Site-Mild, Systemic: Allergic: Rash Generalized-Mild


VAERS ID: 1706455 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-12
Onset:2021-09-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30130BA / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Fatigue, Flushing, Hypotension, Lethargy, Vision blurred, Visual impairment
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hypersensitivity (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Exhaustion / Lethargy-Severe, Systemic: Flushed / Sweating-Mild, Systemic: Hypotension-Severe, Systemic: Visual Changes/Disturbances-Medium, Systemic: Weakness-Severe, Additional Details: Patient became extremely lethargic while sitting on the chair 2 to 3 mins after receive first dose of pfizer covid-19 vaccination. Alert and oriented x3, c/o intermitent blurry vision, Bp 73/28 HR 108. Asked for water, given above 5oz. No s/s allergic reaction. Taken to ER by ambulance 4 to 5mins later while still extremely lethargic.


VAERS ID: 1706457 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-12
Onset:2021-09-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30130BA / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Epistaxis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Dizziness / Lightheadness-Mild, Additional Details: SEVERE NOSE BLEED THAT LASTED ABOUT 5-10 MINUTES


VAERS ID: 1706458 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-09-12
Onset:2021-09-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939901 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Flushing, Hyperhidrosis, Syncope, Unresponsive to stimuli, Visual impairment
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Fainting / Unresponsive-Severe, Systemic: Flushed / Sweating-Medium, Systemic: Visual Changes/Disturbances-Severe


VAERS ID: 1706487 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-09-12
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abnormal faeces, Lacrimal disorder, Skin odour abnormal, Urine odour abnormal
SMQs:, Biliary system related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Lacrimal disorders (narrow), Noninfectious diarrhoea (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210921524

Write-up: UNUSUAL ODOR PRESENT IN URINE; UNUSUAL ODOR PRESENT IN STOOLS; UNUSUAL ODOR PRESENT EVEN ON THE SKIN WHEN SHOWERED; UNUSUAL ORDER PRESENT IN OCULAR TEARS; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) dose was not reported, administered on 11-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 12-SEP-2021, the patient experienced unusual odor present in urine. On 12-SEP-2021, the patient experienced unusual odor present in stools. On 12-SEP-2021, the patient experienced unusual odor present even on the skin when showered. On 12-SEP-2021, the patient experienced unusual order present in ocular tears. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the unusual odor present in urine, unusual odor present in stools, unusual odor present even on the skin when showered and unusual order present in ocular tears was not reported. This report was non-serious.


VAERS ID: 1706490 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Massachusetts  
Vaccinated:0000-00-00
Onset:2021-09-12
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Periorbital swelling, Sensitive skin, Skin irritation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Dermal filler injection
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210921602

Write-up: SWELLING UNDERNEATH THE EYE; SKIN UNDER EYE IS LITTLE SENSITIVE; SKIN UNDER EYE IS IRRITATED; This spontaneous report received from a consumer concerned a 60 year old of unspecified sex. The patient''s height, and weight were not reported. The patient''s past medical history included: dermal filler in cheeks. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 206A21A, and expiry: 21-SEP-2021) dose was not reported, administered on 07-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 12-SEP-2021, the patient experienced swelling underneath the eye. On 12-SEP-2021, the patient experienced skin under eye is little sensitive. On 12-SEP-2021, the patient experienced skin under eye is irritated. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from swelling underneath the eye, skin under eye is irritated, and skin under eye is little sensitive. This report was non-serious.


VAERS ID: 1706492 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Ohio  
Vaccinated:0000-00-00
Onset:2021-09-12
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Ageusia, Taste disorder
SMQs:, Taste and smell disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PREDNISONE; PLAQUENIL
Current Illness: Abstains from alcohol; Blood pressure high; High cholesterol; Lupus erythematosus; Non-smoker; Rheumatoid arthritis
Preexisting Conditions: Comments: In youth tried several illicit drug usage, now has medical marijuana and vaporizes marijuana on an as needed bases.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210921627

Write-up: SENSE OF TASTE GONE; STRANGE TASTE IN MOUTH; This spontaneous report received from a patient concerned a 60 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: rheumatoid arthritis, non-alcohol use, non-smoker, lupus, high blood pressure, and high cholesterol, and other pre-existing medical conditions included: In youth tried several illicit drug usage, now has medical marijuana and vaporizes marijuana on an as needed bases. The patient was previously treated with memantine hydrochloride for high blood pressure, high cholesterol, omeprazole, ezetimibe, tramadol, folic acid, zinc; and experienced hives and swelling when treated with acetylsalicylic acid. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A expiry: UNKNOWN) dose was not reported, administered on 10-SEP-2021 for prophylactic vaccination. Concomitant medications included hydroxychloroquine phosphate for lupus, and prednisone for rheumatoid arthritis. On 12-SEP-2021, the patient experienced sense of taste gone. On 12-SEP-2021, the patient experienced strange taste in mouth. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from sense of taste gone, and strange taste in mouth. This report was non-serious.


VAERS ID: 1706512 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: North Carolina  
Vaccinated:0000-00-00
Onset:2021-09-12
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Feeding disorder, Insomnia, Lymphadenopathy, Pyrexia, Tachycardia, Thyroid disorder
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypothyroidism (broad), Hyperthyroidism (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210923706

Write-up: THYROID PROBLEMS; TACHYCARDIA/UNCONTROLLED RAPID HEART RATE; UNABLE TO SLEEP; UNABLE TO EAT; ENLARGED LYMPHNODES; FEVER; This spontaneous report received from a consumer concerned a 29 year old white, not hispanic or latino female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of administration not reported, batch number: Unknown expiry: Unknown) dose was not reported, 1 total was administered on an unspecified date in MAR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported On 12-SEP-2021, the patient experienced tachycardia/uncontrolled rapid heart rate, and was hospitalized on same day. On an unspecified date and month in 2021, the patient had ongoing signs and symptoms related to thyroid problems and was hospitalized on 12-SEP-2021.On an unspecified date, the patient was unable to sleep, unable to eat, had enlarged lymphnodes, and fever. The patient was hospitalized for 1 day and was discharged on 12-SEP-2021 The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from thyroid problems, and the outcome of unable to sleep, unable to eat, enlarged lymphnodes, tachycardia/uncontrolled rapid heart rate and fever was not reported. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0- 20210923706-covid-19 vaccine ad26.cov2.s-tachycardia/uncontrolled rapid heart rate, Thyroid problems. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1706548 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Virginia  
Vaccinated:0000-00-00
Onset:2021-09-12
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820096 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Headache, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcohol use (1-2 drinks per month .); Non-smoker
Preexisting Conditions: Comments: The patient had no known drug allergies and no drug abuse or illicit drug usage .
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210924850

Write-up: FATIGUE; HEADACHE; MUSCLE SORENESS ALL OVER; This spontaneous report received from a patient concerned a 38 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: alcohol use, and non smoker, and other pre-existing medical conditions included: The patient had no known drug allergies and no drug abuse or illicit drug usage . The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1820096, expiry: 21-OCT-2021) dose was not reported, administered on 11-SEP-2021 16:30 for prophylactic vaccination. No concomitant medications were reported. On 12-SEP-2021, the patient experienced fatigue. On 12-SEP-2021, the patient experienced headache. On 12-SEP-2021, the patient experienced muscle soreness all over. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from fatigue, headache, and muscle soreness all over on 13-SEP-2021. This report was non-serious.


VAERS ID: 1706921 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-07
Onset:2021-09-12
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Herpes zoster, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Diagnosis on September 16th.
CDC Split Type:

Write-up: Shingles, painful rash on torso, started 5 days after second dose.


VAERS ID: 1707603 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-12
Onset:2021-09-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051E21A / 2 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium


VAERS ID: 1707606 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-11
Onset:2021-09-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058E218 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site bruising, Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Site: Bruising at Injection Site-Medium, Site: Itching at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium


VAERS ID: 1707980 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-09-08
Onset:2021-09-12
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Deep vein thrombosis, Fibrin D dimer increased, Ultrasound Doppler abnormal
SMQs:, Haemorrhage laboratory terms (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Dovato, Lyrica, Sildenafil, Lexapro
Current Illness:
Preexisting Conditions: HIV, OSA, HLD, hx of DVT in the same leg couple years ago (resolved)
Allergies: shellfish
Diagnostic Lab Data: Doppler Ultrasound Elevate D-dimer
CDC Split Type:

Write-up: DVT left peroneal vein


VAERS ID: 1707991 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-12
Onset:2021-09-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 1 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Interchange of vaccine products
SMQs:, Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Error: Wrong vaccine formulation (ex. different manufacturer initial and booster).


VAERS ID: 1708034 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-09-12
Onset:2021-09-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Flushing, Hyperhidrosis, Muscle rigidity, Pallor, Pulse abnormal, Syncope, Unresponsive to stimuli, Visual impairment
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Mild, Systemic: Visual Changes/Disturbances-Mild, Additional Details: After administration he was fine for about 30 seconds. While in the chair he tilted his head back and became rigid then slumped over. I tried to awake him but he did not respond and became pale. His pulse was weak. I yelled into the pharmacy to call 911 . When I looked back his hands flew up in the air and he looked around. Upon talking to him he had passed out after piercings but never a shot. The EMTs checked his vitals they were ok and his parents picked him up.


VAERS ID: 1708324 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-10
Onset:2021-09-12
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Bell's palsy, Facial paralysis, Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: cholecalciferol (VITAMIN D3 GUMMIES) 25 MCG (1000 UT) chewable tablet Multiple Vitamins-Minerals (EMERGEN-C IMMUNE PLUS/VIT D PO) Pediatric Vitamins (MULTIVITAMIN GUMMIES CHILDRENS PO)
Current Illness: NA
Preexisting Conditions: None
Allergies: NA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Unilateral Bell?s palsy. Onset was 9.12.21. 2nd dose of Pfizer vaccine was August 10th so she is about 4 weeks out CHIEF COMPLAINT: NUMBNESS and FACIAL DROOP Assessment/Plan - DIAGNOSIS at time of disposition: 1. Bell''s palsy MEDICAL DECISION MAKING Supervising Physician: Dr. This is a 13-year-old previously healthy female presenting with 5 hours of complete left-sided facial droop without any other associated symptoms. Patient is very well-appearing in no acute distress upon arrival with normal vital signs. Patient has a GCS of 15, A&O x4. Patient does have complete left-sided facial droop including the forehead making this most consistent with Bell''s palsy and not a central neurologic process such as stroke. Patient has no other neuro deficits on exam. I did speak with Neurology who agreed with the diagnosis and advised on 1000 mg of Valtrex 3 times daily for a week and prednisone burst with taper over total of 10 days. Patient was given 1st dose of both these medications here in the emergency department. Patient will follow up with Neurology in 4-6 weeks. Patient is also unable to fully close her left eye and therefore was given eye drops, eye gel for night and a eye patch which she was advised to wear while sleeping. Dad was agreeable with this plan patient was discharged home in stable condition. Medications valACYclovir (VALTREX) tablet 1,000 mg (has no administration in time range) glycerin-hypromellose-PEG 400 (ARTIFICIAL TEARS) ophthalmic solution 1 drop (has no administration in time range) predniSONE (DELTASONE) tablet 50 mg (50 mg Oral Given 9/12/21 1536)


VAERS ID: 1708364 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-09-12
Onset:2021-09-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145B4 / 1 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Blood test abnormal, Chest discomfort, Chest pain, Dyspnoea, Heart rate increased, Inflammation, Painful respiration, X-ray abnormal
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: No per-exhsiting
Allergies: None that I know of at this time.
Diagnostic Lab Data: X Ray and blood test on September 15th 2021.
CDC Split Type:

Write-up: About 4 hours after the injection I started having some chest pain, faint breathing, and elevated heart. Was not sure if it was normal and the forms said see a doctor if symptoms persist. 48 hours later the chest pain went down but every time I took a deep breath i felt pressure against chest, I could not take a deep breath or a good yawn, heart rate increased quickly with minor movement, with faint breathing. Saw primary care and directed me to ER for X ray scan and blood test. Test showed heart was okay but diagnoses was inflammation in the lining of my lungs. Prescribed prednisone for the next 3 days and directed to take ibuprofen to help with pain/inflammation.


VAERS ID: 1708367 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-03-31
Onset:2021-09-12
   Days after vaccination:165
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016B21A / 2 - / -

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Chest X-ray, Cough, Diarrhoea, Dyspnoea, Electrocardiogram, Fatigue, Full blood count, Metabolic function test, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: allopurinol 300mg daily alprazolam 1mg TID amlodipine 10mg daily in PM aspirin 81mg daily carvedilol 25mg BID Cyanocobalamin 500mcg daily escitalopram 20mg BID ferrous sulfate 325mg three times per week furosemide 20mg daily gabapentin 100m
Current Illness: None documented
Preexisting Conditions: hypertension, hypercholesterolemia, hypothyroidism, anxiety, gout, urinary incontinence, radiation proctitis, lipoma of colon, actinic keratosis, acute eczema, edema, chronic renal failure, impaired glucose tolerance, hyperkalemia, leukopenia, macrocytosis, neoplasm of prostate, pharyngeal dysphagia, degenerative joint disease, pruritus ani, seborhea, stress incontinence, vitamin B12 deficiency, renal colic,
Allergies: amitriptyline - hyperactivity amoxicillin - nausea atenolol - bradycardia Lipitor - elevated liver enzymes nortriptyline - Hyperactivity Pravachol - myalgia tenormin - shaking, anxiety cough toprol -xr = shaking, anxiety, cough tranexamic acid - contraindication vicodin - hyperactivity and tachycardia Zocor - elevated liver enzymes
Diagnostic Lab Data: CBC, CMP, on 9/16/2021 Chest xray and EKG on 9/16/2021
CDC Split Type:

Write-up: Patient contracted COVID after being fully vaccinated 9/12/2021 start of symptoms - shortness of breath, fever, diarrhea, fatigue, cough Admitted to the hospital on 9/16/2021


VAERS ID: 1708413 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-10
Onset:2021-09-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Axillary pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: When she was a baby, she did have a knot on her both of her thighs.
Other Medications: Iron; vitamin D
Current Illness: None
Preexisting Conditions: ADHD; Bipolar; Panic Attack; Asthma; Anxiety
Allergies: None
Diagnostic Lab Data: None
CDC Split Type: vsafe

Write-up: My daughter explained she had a lump under her arm pits. Doctor told us to put hot towel under arm. The lump is still there just does not hurt as bad.


VAERS ID: 1708485 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-01
Onset:2021-09-12
   Days after vaccination:195
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNK / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Chest X-ray normal, Dyspnoea, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Buspirone 10mg, Calcium carbonate-Vitamin D3 600mg-400mg, Aricept, Flonase, Lasix 40mg, gabapentin 100mg, insulin, levothyroxine 150mg, melatonin, metformin, Womens 50+ Advanced vitamins, Prilosec 20mg, zofran, Zoloft 50mg, zocor 20mg, Alda
Current Illness: DM type II, Depression, COPD, DLD
Preexisting Conditions: DM type II, Depression, COPD, DLD, thyroid disease, stroke, HCC, iron deficiency anemia, GERD, Basal ganglia hemorrhagic stroke, CHF, Carpal tunnel syndrome, arthritis
Allergies: Penicillins
Diagnostic Lab Data: COVID-19 PCR Positive 9/14/21 Chest X-rays 9/16/21 - The cardiomediastinal contours and pulmonary vasculature are within normal limits. The lungs are clear. There is no pneumothorax or pleural effusion. Redemonstrated are multiple old left-sided rib fractures. There is also irregularity involving the left AC joint due to prior trauma.
CDC Split Type:

Write-up: Patient completed Moderna COVID-19 vaccination on 3/1/21. Lot number is not specified in the medical records. Patient was admitted to reporting hospital on 9/12/21 after complaints of shortness of breath and fever. Pt was found to be COVID positive the day prior at her resident facility. EMS was activated due to worsening symptoms and a pulse ox of 91%. Admitting PCR test for COVID-19 was positive on 9/12/21. Patient was discharged on 9/15/21, but then later readmitted on 9/16/21. She is currently admitted.


VAERS ID: 1708511 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-03
Onset:2021-09-12
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 062E21A / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: HYPERTENSION
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: LARGE RED SWELLING AND PAIN AT INJECTION SITE 10 DAYS AFTER ADMINISTRATION, VERY WARM TO TOUCH, 3 DAYS AFTER INITIAL SWELLING, A RED RING APPEARED AROUND THE SITE AND LASTED FOR ANOTHER 4 DAYS.


VAERS ID: 1708571 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-01-15
Onset:2021-09-12
   Days after vaccination:240
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027L20A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027L20A / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Condition aggravated, Pancreatitis acute, SARS-CoV-2 test positive
SMQs:, Acute pancreatitis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zoloft, sudafed, melatonin, climara
Current Illness:
Preexisting Conditions: Acute pancreatitis, viral diarrhea, hypokalemia, anxiety
Allergies: metronidazole, sulfamethoxazole trimethoprim
Diagnostic Lab Data: Swabbed positive on admission 9/12/21
CDC Split Type:

Write-up: Acute pancreatitis


VAERS ID: 1708590 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-11
Onset:2021-09-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, C-reactive protein normal, Chest X-ray normal, Chest pain, Dizziness, Dyspnoea exertional, Electrocardiogram normal, Nausea, Red blood cell sedimentation rate normal, Vaccine positive rechallenge
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ibuprofren, tylenol, benadryl
Current Illness: none
Preexisting Conditions: none
Allergies: peanuts, hazelnuts, pecans, walnuts
Diagnostic Lab Data: On Tues Sept 14: C reactive protein, sed rate, EKG, chest xray (I believe all results were normal)
CDC Split Type:

Write-up: Symptoms occured after both first dose (Aug 21) and second dose (Sept ). Intermittent episodes of chest and upper back pain sometimes accompanied by shortness of breath, dizziness and nausea, beginning 3 days after the first dose and resolved after about day 5. With second dose symptoms began the next day and escalated over several days, still ongoing now (7 days later) but some improvement compared to 2 days ago. Symptoms usually occurred with light exertion (attempting usual activities which normally do not cause these symptoms).


VAERS ID: 1708606 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-13
Onset:2021-09-12
   Days after vaccination:183
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Work       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: PATIENT EXPERIENCED CHEST PAINS AFTER RECEIVING JASSEN VACCINE
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT HAD JANSSEN VACCINE ON 03/13/2021, AND TESTED POSITIVE TO COVID.


VAERS ID: 1708651 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-06-30
Onset:2021-09-12
   Days after vaccination:74
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FW0181 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FW7485 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysmenorrhoea
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Migraine
Allergies: Nickle
Diagnostic Lab Data:
CDC Split Type:

Write-up: Intense Menstrual Cramps


VAERS ID: 1708792 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-11
Onset:2021-09-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301358A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bacterial infection, Breast pain, Dizziness, Erythema, Fatigue, Feeling abnormal, Hypersensitivity, Influenza, Myalgia, Nervousness, Night sweats, Pruritus, Skin warm, Swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Dementia (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Lipodystrophy (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamins: Omega3 Fish 1400mg x 1, Co-Q 10 100 mg x 1; D3 2000BU x 2; C 500mg x 2'' Calcium Citrate Magnesium and Zinc x 2; baby aspirin
Current Illness: none
Preexisting Conditions: n/a
Allergies: Penicillin
Diagnostic Lab Data: n/a - I met with the Doctor via virtual visit. The red reaction was still visible but not to the original start of the reaction. I did take 2 photos on my mobile.
CDC Split Type:

Write-up: I am reporting on dose #2 however for dose #1 I had a red circle the size of a 50 cent coin around the injection with no other issues. For dose #2 my left upper arm turned major red the next day and grew in size over progressive days to a minimum size like a pizza slice and bigger and was HOT to the touch and felt itchy. The reaction was my main concern I monitored. Meanwhile, I dealt with traditional flu side effects with major tiredness on the 3rd day, major night sweating, blah feelings, and by Thurs. shaky and light-headedness. I also experienced muscle pain in my underarm and breast area on the left arm where the dose was given. Treatments included sleep when I could get it, started a Tylenol and Ibuprofen on Tues-9/13/21 with a benedryl also started afterwards per Pharmacist with follow up to Doctor at 4:30p per direction which occurred on Thurs, 9/16/21 where I was prescribed Azithromyci 250mg 6-pak and Pendnisone 20mg (up to 5 tablets as needed) to address the allergic reaction and bacterial infection. I have been informed I am not a candidate for the booster and will be collecting acknowledgement from my pharmacist.


VAERS ID: 1708901 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-09-12
Onset:2021-09-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821281 / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Dyspnoea, Flushing, Oropharyngeal discomfort, Pharyngeal oedema, Taste disorder, Throat irritation
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Taste and smell disorders (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None reported.
Current Illness: None known
Preexisting Conditions: Motor vehicle accident 9/18/2018; L arm injury/nerve injury status post surgical repair 9/18/2018
Allergies: NKA
Diagnostic Lab Data: Patient was administered one dose of epinephrine via autoinjector and given supplemental oxygen via facemask. He was then transferred by EMS to local hospital for ED evaluation and later released.
CDC Split Type:

Write-up: Patient first reported taste of soap and berries, within 10-15 minutes of administration. He was monitored by EMTs for the mandatory 15 minutes, then left the vaccine site. He returned to his workplace and came back to the location with flushing, throat irritation, throat edema, dyspnea. Throat feels funny, I can only breathe if I tip my head back.


VAERS ID: 1709072 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-11
Onset:2021-09-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 062E21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Discharge, Injection site pruritus, Injection site rash, Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Morphine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Received shot on Saturday 09/11/21. Sunday 09/12/2021 my under arm of my left arm, which is the arm I recieved the vaccine in, started itching and developing a rash. It continued to get worse. I have a mole on my arm pit and on Wednesday 09/15/2021 I noticed what looked to be pus leaking out from my mole. I also had a lump underneath said mole and when pushed the mole would leak more pus. I went to a urgent care clinic on 09/16/2021 and they did not confirm if it was from the vaccine or not but issue started after vaccine


VAERS ID: 1709095 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Unknown  
Vaccinated:2020-12-23
Onset:2021-09-12
   Days after vaccination:263
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Work       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT HAD PFIZER COVID-19 DOSES, Dose 1 date: 12/23/2020, Dose 2 date: 01/13/2021. PATIENT TESTED POSITIVE TO COVID.


VAERS ID: 1709115 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-10
Onset:2021-09-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Rash, Rash erythematous, Rash pruritic, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Peanuts, walnuts and almonds
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Cheeks was red with bumps, itching and swollen. I used Claritin and that helped.


VAERS ID: 1709146 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-11
Onset:2021-09-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / 1 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Phlebitis
SMQs:, Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamin C, Vitamin D, Zinc.
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: visible phlebitis in vein on left temple.


VAERS ID: 1709199 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-12
Onset:2021-09-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Burning sensation, Limb immobilisation, Myalgia, Neuralgia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: going into ER again on 9/17/2021 requesting ultrasound testing
CDC Split Type:

Write-up: burning instanly in shoulder. after couple hours severe shoulder pain. Immobility of the arm, nerve sensation and excruciating pain. Pain has persisted in its 5th day as of report. Seen in an ER. DIagnosed as muscle nerve pain


VAERS ID: 1709225 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-26
Onset:2021-09-12
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Herpes zoster, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Exercise induced athsma
Allergies: None
Diagnostic Lab Data: Clinic visit, prescribed Valacyclovir 3x per day for 7 days starting on 9/15/2021
CDC Split Type:

Write-up: Developed shingles on right posterior, right testicle, between legs. Followed by fever and consistent headache which have subsided, shingles still present. IMPORTANT: NEVER HAD CHICKEN POX Received chicken pox vaccination and booster as infant.


VAERS ID: 1709473 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-09-12
Onset:2021-09-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling abnormal, Feeling hot, Headache, Injection site erythema, Injection site mass, Injection site pruritus, Injection site swelling, Injection site warmth, Mental impairment, SARS-CoV-2 test, Somnolence, Speech disorder, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Asthma
Allergies: Ciprofloxacin Ciprofloxacin Anaphylaxis, Itching High 7/10/2017 Past Updates Rocephin [Ceftriaxone] Rocephin [Ceftriaxone] Anaphylaxis High 8/19/2017 Past Updates Zithromax [Azithromycin] Zithromax [Azithromycin] Anaphylaxis High 8/19/2017 Past Updates Uncoded Nonscreenable Allergen Not Specified 4/16/2016 Past Updates Pt states "i''m allergic to some abx but i don''t know what the names is. i get itchy and feel like it can''t breath and get hot inside"
Diagnostic Lab Data: Repeat covid test at urgent care, awaiting results. 9/17/2021
CDC Split Type:

Write-up: Patient complains of vaccine reaction after getting COVID vaccine on Sunday, "I just feel dumb", "I don''t know what is happening", "it feels less today", "thinking and speaking were hard", "really drowsy" the next day, "feeling better today", "red lump where I got the injection", "swollen, itchy, warm" just noticed today in the morning, some swelling of face on Tuesday but resolved next day, "I took Tylenol with relief", "headache that doesn''t go away" "5/10, not painful just annoying" "felt warm inside". 9/16/2021


VAERS ID: 1709632 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-12
Onset:2021-09-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: vaccine was administered after being improperly. the should have been moved for the freezer on 9/2, but was not removed until 9/8 and was administered to the patient


VAERS ID: 1710052 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-08-16
Onset:2021-09-12
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045C21A / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy
SMQs:, Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: warfarin metropolol methotraxate folic acid
Current Illness: Rheumatoid Arthritis Atrial Fib
Preexisting Conditions: See Above
Allergies: hexachlorophene
Diagnostic Lab Data: Confirmed by Ophthalmologist
CDC Split Type:

Write-up: Bell''s Palsy


VAERS ID: 1712012 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-09-11
Onset:2021-09-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / 2 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache, Lymphadenopathy, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101192023

Write-up: Swollen supraclavicular lymph node (right); Fever; Muscle aches; Headache; Fatigue; This is a spontaneous report from a contactable consumer, the patient. A 41-year-old non-pregnant female patient received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: 30135BA) via an unspecified route of administration in the right arm on 11Sep2021 at 12:45 (at the age of 41-years-old) as a single dose for COVID-19 immunisation. Medical history was unknown. The patient had no known allergies. Prior to vaccination, it was unknown whether the patient was diagnosed with COVID-19. The patient did not receive any concomitant medications. The patient did not receive any other vaccines within four weeks prior to the COVID vaccine. The patient previously received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FD8448) via an unspecified route of administration in the right arm on 20Aug2021 at 09:00 (at the age of 41-years-old) as a single dose for COVID-19 immunisation. On 12Sep2021 at 01:15, the patient experienced swollen supraclavicular lymph node (right), fever, muscle aches, headache, and fatigue. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Since the vaccination, the patient had not been tested for COVID-19. Therapeutic measures were not taken as a result of the events. The clinical outcome of the events swollen supraclavicular lymph node (right), fever, muscle aches, headache, and fatigue were not resolved at the time of this report.


VAERS ID: 1712051 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-09-11
Onset:2021-09-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Dysmenorrhoea, Intermenstrual bleeding, Menstruation irregular
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Fertility disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: COMPLERA
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Human immunodeficiency virus syndrome (Hiv)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101197141

Write-up: Cramping; Spotting; Not supposed to start period for another week; This is a spontaneous report from a contactable other healthcare professional, the patient. A 34-year-old non-pregnant female patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 11Sep2021 at 10:30 (at the age of 34-years-old) as a single dose for COVID-19 immunisation. Medical history included human immunodeficiency virus syndrome (HIV). Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. Concomitant medication included emtricitabine, tenofovir disoproxil fumarate, rilpivirine hydrochloride (COMPLERA) for an unknown indication from an unknown date and unknown if ongoing. On 12Sep2021 at 09:00, the patient was not supposed to start period for another week, however she had uncomfortable cramping and spotting which were still ongoing two days after. The patient never had these symptoms before. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Therapeutic measures were not taken as a result of the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events cramping, spotting and not supposed to start period for another week were not resolved at the time of this report.


VAERS ID: 1712063 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-09-12
Onset:2021-09-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Balance disorder, Dizziness, Nausea, Photosensitivity reaction
SMQs:, Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101197930

Write-up: Sensitive to light; Loss of balance; Stomach pain; Lightheaded; Nauseous; This is a spontaneous report from a contactable consumer, the patient. A 29-year-old non-pregnant female patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 12Sep2021 at 14:00 (at the age of 29-years-old) as a single dose for COVID-19 immunisation. The patient had no medical history and no known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. The patient did not receive any concomitant medications. On 12Sep2021 at 18:00, the patient had been sensitive to light, lightheaded, experienced stomach pain and felt nauseous and loss of balance. The events did not result in doctor or other healthcare professional office/clinic visit, and emergency room/department or urgent care. Therapeutic measures were not taken as a result of the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events sensitive to light, lightheaded, stomach pain, nauseous and loss of balance was not resolved at the time of the report. The lot number for BNT162b2 was not provided and will be requested during follow up.


VAERS ID: 1712094 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-10
Onset:2021-09-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (Prior to vaccination)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101205109

Write-up: Skin rash; This is a spontaneous report from a non-contactable consumer, the patient. A 20-year-old non-pregnant female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FC3183) via an unspecified route of administration in the left arm on 10Sep2021 at 16:30 (at the age of 20-years-old) as a single dose for COVID-19 immunisation. Prior to the vaccination, the patient was diagnosed with COVID-19. The concomitant medications were not reported. The patient did not receive any other vaccine within four weeks prior to the COVID-19 vaccine. On 12Sep2021, the patient experienced skin rash. The events did not result in doctor or other healthcare professional office/clinic visit, and emergency room/department or urgent care. No therapeutic measures were taken as a result of skin rash. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the event skin rash was not recovered at the time of this report. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1712098 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-12
Onset:2021-09-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Diarrhoea, Headache, Nasal congestion, Nausea, Oropharyngeal pain, Pain, Pain in extremity, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Cystitis interstitial (Interstitial cystitis); Fibromyalgia; Lichen sclerosus (Lichens scherosis); Spinal stenosis; Sulfonamide allergy (Known allergy: Sulfa)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101205935

Write-up: Chills; Severe headache/headache worse when bending over; Fever; Queasy stomach/nausea; Diarrhea; Severe arm pain; Achiness; Stuffy nose; Sore throat; This is a spontaneous report from a non-contactable consumer, the patient. A 64-year-old non-pregnant female patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot number: UNKNOWN) via an unspecified route of administration in the right arm on 12Sep2021 at 12:30 (at the age of 64-years-old) as a single dose for COVID-19 immunisation. Medical history included fibromyalgia, spinal stenosis, interstitial cystitis, lichen sclerosus and known allergies to sulfa. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. The patient did not receive concomitant medications. On 12Sep2021 at 23:00, the patient experienced chills, severe headache, fever, queasy stomach/diarrhea, severe arm pain, achiness, stuffy nose, sore throat, nausea. It was reported as headache was worse when bending over. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Therapeutic measures were not taken as a result of the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events chills, severe headache/headache worse when bending over, fever, queasy stomach/nausea, diarrhea, severe arm pain, achiness, stuffy nose, and sore throat was unknown at the time of this report. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.


VAERS ID: 1712127 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-23
Onset:2021-09-12
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Menstrual disorder
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101211880

Write-up: most recent period "seems different" and is "redder, heavier, and more clotting" than normal; most recent period "seems different" and is "redder, heavier, and more clotting" than normal; This is a spontaneous report from a contactable 50-year-old female consumer reported for herself via medical information team. A 50-year-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Batch/Lot number: Unknown), via an unspecified route of administration on 23Aug2021 as single for covid-19 immunisation. The patient''s medical history and concomitant medications were not reported. She reported that her most recent period "seems different" and was "redder, heavier, and more clotting" than normal, her period started on 12Sep2021. She''s also seen social media reports of changes in menstruation. She''s decided not to take the second dose. She did indicate she was approaching menopause, and that she has an appointment scheduled with her doctor. She experienced changes in her menstrual cycle after receiving the first dose of the Pfizer-Biontech Covid19 vaccine. She asked, the vaccine does require an immune response, right? Could that cause changes in her menstrual cycle? She was asking have other people reported similar changes to menses after vaccination? Will there be additional studies looking into menstrual changes? No studies for changes in menstruation. Provided that there was an arm of the study that focuses on pregnant women. The Comirnaty Prescribing Information and the authorized Prescribing Information for the Pfizer-BioNTech COVID-19 Vaccine do not list menstrual changes as adverse reaction from clinical studies and post authorization experience. The organization that provides leadership in education, research and gynecologic care to improve the reproductive health of young people states that: There have been anecdotal and media reports of irregular menstrual cycles, including skipped periods, prolonged periods, spotting after COVID-19 vaccines in adults and similar changes in menstrual cycles have been reported after COVID-19 infection. This was not surprising because infections, immune reactions, and fevers can cause short-term, self-limited changes in cycles. However, further studies are needed to verify these changes in people who have received COVID-19 vaccines. Reporter considered events as non-serious. The outcome of events was unknown. The lot number for BNT162b2 was not provided and will be requested during follow up.


VAERS ID: 1713341 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-09-11
Onset:2021-09-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK UN / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Echocardiogram normal, Electrocardiogram normal, Troponin increased
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: NKA
Diagnostic Lab Data: Troponin levels decreased over course of hospitalization from 1.33 to 1.15 to 0.54 over pt''s 3 day observation and cardiac ECHO and EKG''s were normal
CDC Split Type:

Write-up: Pt. had chest pain and shortness of breath.


VAERS ID: 1713438 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-12
Onset:2021-09-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0810 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Electrocardiogram, Headache, Heart rate increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: No
Allergies: None
Diagnostic Lab Data: ECG
CDC Split Type: Canadian

Write-up: Difficulties breathing, rapid heart beat, headache


VAERS ID: 1713461 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-09-12
Onset:2021-09-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO217 / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Hypoaesthesia, Pain in extremity, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin
Current Illness: None
Preexisting Conditions: Hashimoto''s diagnosis (monitoring with lab values only, never medicated or treated.)
Allergies: None known
Diagnostic Lab Data: First time reporting, no follow up yet
CDC Split Type:

Write-up: Numbness, tingling, aching in left arm following vaccine Administration and still present.


VAERS ID: 1713613 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-09-11
Onset:2021-09-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046C2LA / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Haemoptysis, Headache, Increased viscosity of upper respiratory secretion, Respiratory tract congestion, Upper-airway cough syndrome
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none that I know of
Preexisting Conditions: none
Allergies: none that I know of
Diagnostic Lab Data:
CDC Split Type:

Write-up: 1st day was fine 2nd day I had headaches like I never had before in my life 3rd day still the same headaches and spitting blood from my lungs 4th - 7th day am still congested like I have never been before in my life. Have been congested from day 2 - 7th, heavy congestion (very thick mucus and a constant nasal drip).


VAERS ID: 1713624 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-09
Onset:2021-09-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal distension, Abdominal pain upper, Cardiac disorder, Chest discomfort, Chest pain, Dyspnoea, Fatigue, Flatulence, Gastrointestinal disorder, Hypoaesthesia, Muscle fatigue, Muscle spasms, Nausea, Oropharyngeal pain, Pain, Pain in extremity, Palpitations, Pyrexia, Sneezing, Vaginal discharge
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: n/a
Preexisting Conditions: anorexia nervosa
Allergies: unknown
Diagnostic Lab Data: Health insurance won''t cover and could not get treatment
CDC Split Type:

Write-up: MOST PROMINENT SYMPTOM OF NOTE: HEART ISSUES AFTER VACCINATION Day 1: Sore arm; gastrointestinal Day 2: Sore arm; gastrointestinal Day 3: sore arm; tired muscles Day 4: sore arm; heart palpitations, shortness of breath, chest pain, tight chest? temp: 100.3 (Resting heart rate is usually around 54 - 58BPM. Resting heart rate was 78 bpm) Day 5: period style bloating (May be unrelated or be kickstarting menstrual cycle early). - Afternoon - nausea, cramps, stomach pain - Evening - fever 99.1. Sore throat Day 6: Tired; left arm numb and achy. Cramps Day 7: Tired. Fever 99.0 Day 8: Fever 99.0. Sneezy. White/yeast discharge Day 9: temp normal. Sharp pain/shooting pain in chest. Major cramps. PAINFUL cramping. So painful. So painful cramping. Gassy. Stomach pain


VAERS ID: 1713910 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Rhode Island  
Vaccinated:2021-08-30
Onset:2021-09-12
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Upper respiratory tract infection
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: Diabetic 2 CHF Hypertension Insomnia
Allergies: Cat Scan Dye
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Severe Upper respiratory infection


VAERS ID: 1713951 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-09-11
Onset:2021-09-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Chills, Headache, Influenza like illness, Lethargy, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Muscle aches
Other Medications: Hemp Products
Current Illness: N/a
Preexisting Conditions: N/a
Allergies: N/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: The night I received the vaccine I was awake at 3 am and felt the chills crawl from my toes to my forehead in which I had flu like symptoms (fever, chills, aches, intense headache) for the whole day the next day. Those symptoms subsided but I''ve felt very lethargic every day since and the passed few days I''ve been having chest pains and pressure near my heart.


VAERS ID: 1714139 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-11
Onset:2021-09-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Headache
SMQs:, Anaphylactic reaction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril-HCTZ 20/12.5 mg, multivitamin
Current Illness: N/A
Preexisting Conditions:
Allergies: Themersol
Diagnostic Lab Data:
CDC Split Type:

Write-up: Intermittent chest pressure and headaches


VAERS ID: 1714311 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-08
Onset:2021-09-12
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthritis, Burning sensation, Pain
SMQs:, Peripheral neuropathy (broad), Systemic lupus erythematosus (broad), Arthritis (narrow), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: shot would say Hashimoto In remission, Allergic Rhinitis
Allergies: Iodine, acetylsalicylic acid, peanuts
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Inflammation of the Joints in both hands, Pain and burning lasting 7 continuous days


VAERS ID: 1714318 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-09-12
Onset:2021-09-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Dizziness, Dyspnoea, Eye pain, Fatigue, Head discomfort, Headache, Heavy menstrual bleeding, Intermenstrual bleeding, Muscle tightness, Myalgia, Pain in extremity, Paraesthesia, Tenderness
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Anthrax vaccine, age 21, dates unknown, reaction was continued fever for approx 1 week, large swollen lymph nodes in arm pit, in
Other Medications: Mirena
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Tingling back of my head right side (day of shot only) Dizzy (lasted 5 days) Difficulty getting full breath, have to breath hard to feel like lungs are full (lasted 5 days) Dry Coughing (lasted 6 days) Left eye pain (day after shot only) Extreme fatigue (lasted 7 days) Headache in both sections of back of head (head pressure at base of skull) (lasted 5 days) Tight neck muscles (lasted 3 days) Left arm pain in muscle near injection site, not at injection site. Could barely move it day after shot. Still painful to touch day2 (gone by day 3) Started having blood clots / very heavy period 2nd day (just got over period 6 sep) (bleeding has slowed to spotting and periodic ?breakthrough bleeding requiring panty liner and/or tampon. Ongoing as of day 8)


VAERS ID: 1714432 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-11
Onset:2021-09-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Flank pain, Gait disturbance, Haematuria, Pain, Pyrexia
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine, Crestor, Labetalol, Cardizem, Vitamins B6, B12, D3, C, Fish Oil, Folic Acid
Current Illness: None
Preexisting Conditions: Hashimoto''s Thyroiditis, IGA Nephropathy
Allergies: Mild fruit protein allergy, hay fever
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Extreme fatigue and body aches, making walking difficult; fever range of 100.1-101.4 all day, including chills; gross hematuria noticeable by eye throughout Sep 12 and part of Sep 13; dull left flank pain in area where kidney is located. On Sep 19, noticeable gross hematuria recurred again in the evening, accompanied by dull left flank pain.


VAERS ID: 1714439 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-10
Onset:2021-09-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Epistaxis, Eyelid rash, Fatigue, Headache, Impaired work ability, Injection site mass, Limb mass, Mobility decreased, Nausea, Pain, Peripheral swelling, Pyrexia, Rash, Vomiting
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: None
Preexisting Conditions: None
Allergies: Yes allergic to penicillin, macrobid, and keflex
Diagnostic Lab Data: On 9/14/2021 my job sent me to urgent care where the NP wrote me out of work for the rest of the week.
CDC Split Type:

Write-up: On 9/12/2021 in the morning I felt very tired, chills, fever off and on. By the next day 9/13/2021 I felts body aches, chills , fever, headache, and my right hand/ legs/ feet were swollen. I also had a nose bleed! All these symptoms plus throwing up/ nausea continues into the week. I also broke out with a rash on my face and eyelids. I also had a baseball size lump on my underarm and a lemon sized lump on the injection site. I was bed ridden for about four days


VAERS ID: 1714905 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-08
Onset:2021-09-12
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / UNK RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lotrel 5/20
Current Illness: none
Preexisting Conditions: none
Allergies: iodine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Muscle weakness in the legs when walking for more than Five minutes. Used to walk 2 miles a day. Not treated. Ongoing.


VAERS ID: 1714988 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-01-20
Onset:2021-09-12
   Days after vaccination:235
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Covid positive link unknown


VAERS ID: 1715024 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-18
Onset:2021-09-12
   Days after vaccination:178
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Covid positive household member


VAERS ID: 1715074 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-03-11
Onset:2021-09-12
   Days after vaccination:185
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: shortness of breath, secondary to COVID-19 infection


VAERS ID: 1715239 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-01-21
Onset:2021-09-12
   Days after vaccination:234
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Anosmia, Cough
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: cough, loss of taste and smell


Result pages: prev   103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 265 266 267 268 269 270 271 272 273 274 275 276 277 278 279 280 281 282 283 284 285 286 287 288 289 290 291 292 293 294 295 296 297 298 299 300 301   next

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?EVENTS=ON&PAGENO=202&PERPAGE=100&ESORT=ONSET-DATE&REVERSESORT=ON&VAX=COVID19&DIED=No

Government Disclaimer on use of this data


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166